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– Auto
– Home
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– Paintshop Insurance
– Bikeshop Insurance
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Join Our Team
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CONTACT
Online Commercial Auto Insurance Quote
Home
Online Commercial Auto Insurance Quote
Step 1 of 3
33%
GENERAL INFORMATION
Company Name
*
Name
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Last
Email
*
Daytime Phone
*
Business Type
*
Ref by:
*
POLICY INFORMATION
Do you have a current commercial auto policy?
*
Yes
No
Date
*
Name of Current or Most Recent Insurer
*
Policy Renewal Date or Date Last Insured
*
Policy cancelled in the last 3 years?
Yes
No
If yes, state reason and date:
*
VEHICLE #1 INFORMATION
Registered Name for Vehicle
*
Type:
*
Personal Name
Company Name
Year
*
Make
*
Model
*
Body Type
*
2-Door
Convertible
4-Door
Station Wagon
Pickup
Van
Other
Please Select One
If Other, Please Specify:
*
Date of Vehicle Purchase
*
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
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16
17
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19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
VIN #:
*
Weight of Vehicle
*
More than 4500kg
Less than 4500kg
List Price New
*
Is Vehicle:
*
Owned
Leased
Any Business in U.S.?
*
Yes
No
Percentage of use in U.S.
*
Please Describe Main Usage for Vehicle
*
Liability Limit
*
$1,000,000
$2,000,000
Please select one
Collision Deductible
*
$300
$500
$1,000
$2,500
$5,000
Please Select One
Comprehensive Deductible
*
$300
$500
$1,000
$2,000
$5,000
Please Select One
Loss of Use:
*
Yes
No
Limited Waiver of Depreciation
*
Yes
No
Legal Liability For Non-Owned Vehicles
*
Yes
No
List Machinery & Equipment:
Description
*
Year Manufactured
*
Value
*
Description:
Year Manufactured
Value
Description:
Year Manufactured
Value
Haul any trailers?
*
Yes
No
Use of Trailer
Trailer Type
Trailer Year
Trailer Make
Trailer Model
Trailer Value
Please list the merchandise carried:
Are goods carried for compensation?
*
Yes
No
If yes, is there a contract in place?
*
Yes
No
Hauling for others?
*
Never
Daily
Weekly
If yes, is there a contract in place?
*
Yes
No
Radius of Operations:
Normal Radius: Distance one way (kms):
*
% of total trips:
*
Maximum Radius: Distance one way (kms):
*
% of total trips:
*
Number of trips per month outside of radius:
*
Destinations Travelled to: (Cities, Provinces)
*
Garaged Location of Vehicle
*
Have second vehicle?
Yes
No
VEHICLE #2 INFORMATION
Registered Name for Vehicle
*
Type:
*
Personal Name
Company Name
Year
*
Make
*
Model
*
Body Type
*
2-Door
Convertible
4-Door
Station Wagon
Pickup
Van
Other
Please Select One
If Other, Please Specify:
*
Date of Vehicle Purchase
*
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
VIN #:
*
Weight of Vehicle
*
More than 4500kg
Less than 4500kg
List Price New
*
Is Vehicle:
*
Owned
Leased
Any Business in U.S.?
*
Yes
No
Percentage of use in U.S.
*
Please Describe Main Usage for Vehicle
*
Liability Limit
*
$1,000,000
$2,000,000
Please select one
Collision Deductible
*
$300
$500
$1,000
$2,500
$5,000
Please Select One
Comprehensive Deductible
*
$300
$500
$1,000
$2,000
$5,000
Please Select One
Loss of Use:
*
Yes
No
Limited Waiver of Depreciation
*
Yes
No
Legal Liability For Non-Owned Vehicles
*
Yes
No
List Machinery & Equipment:
Description:
*
Year Manufactured
*
Value:
*
Description:
Year Manufactured
Value:
Description:
Year Manufactured
Value:
Haul any trailers?
*
Yes
No
Use of Trailer
Trailer Type
Trailer Year
Trailer Make
Trailer Model
Trailer Value
Please list the merchandise carried:
Are goods carried for compensation?
*
Yes
No
If yes, is there a contract in place?
*
Yes
No
Hauling for others?
*
Never
Daily
Weekly
If yes, is there a contract in place?
*
Yes
No
Radius of Operations:
Normal Radius: Distance one way (kms):
*
% of total trips:
*
Maximum Radius: Distance one way (kms):
*
% of total trips:
*
Number of trips per month outside of radius:
*
Destinations Travelled to: (Cities, Provinces)
*
Garaged Location of Vehicle
*
Have third vehicle?
Yes
No
VEHICLE #3 INFORMATION
Registered Name for Vehicle
*
Type:
*
Personal Name
Company Name
Year
*
Make
*
Model
*
Body Type
*
2-Door
Convertible
4-Door
Station Wagon
Pickup
Van
Other
Please Select One
If Other, Please Specify:
*
Date of Vehicle Purchase
*
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
VIN #:
*
Weight of Vehicle
*
More than 4500kg
Less than 4500kg
List Price New
*
Is Vehicle:
*
Owned
Leased
Any Business in U.S.?
*
Yes
No
Percentage of use in U.S.
*
Please Describe Main Usage for Vehicle
*
Liability Limit
*
$1,000,000
$2,000,000
Please select one
Collision Deductible
*
$300
$500
$1,000
$2,500
$5,000
Please Select One
Comprehensive Deductible
*
$300
$500
$1,000
$2,000
$5,000
Please Select One
Loss of Use:
*
Yes
No
Limited Waiver of Depreciation
*
Yes
No
Legal Liability For Non-Owned Vehicles
*
Yes
No
List Machinery & Equipment:
Description:
*
Year Manufactured
*
Value:
*
Description:
Year Manufactured
Value
Description:
Year Manufactured
Value:
Haul any trailers?
*
Yes
No
Use of Trailer
Trailer Type
Trailer Year
Trailer Make
Trailer Model
Trailer Value
Please list the merchandise carried:
Are goods carried for compensation?
*
Yes
No
If yes, is there a contract in place?
*
Yes
No
Hauling for others?
*
Never
Daily
Weekly
If yes, is there a contract in place?
*
Yes
No
Radius of Operations:
Normal Radius: Distance one way (kms):
*
% of total trips:
*
Maximum Radius: Distance one way (kms):
*
% of total trips:
*
Number of trips per month outside of radius:
*
Destinations Travelled to: (Cities, Provinces)
*
Garaged Location of Vehicle
*
DRIVER #1 INFORMATION
Name
First
Last
Age
Gender
Male
Female
Prefer Not to Answer
Drives Which Vehicle?
Vehicle #1
Vehicle #2
Vehicle #3
Please select all that apply.
Percentage of use of this vehicle:
How long licensed?
Previous Commercial Experience
None
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
More than 6 Years
Please Select One
Number of years experienced driving listed vehicle or similar type of vehicle
Drivers License No.
License Expiry Date
YYYY
MM
DD
License Dates:
All fields below are required. If not applicable, please indicate N/A.
G (yyyy/mm)
G1 (yyyy/mm)
G2 (yyyy/mm)
A (yyyy/mm)
AZ (yyyy/mm)
Other Class Type & Date (yyyy/mm)
Approved Driver's Training
Yes
No
Consecutively insured for:
None
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7+ Years
Please Select One
Minor Convictions in the past 3 years:
Yes
No
If yes, provide dates and types:
Major Violations in the past 3 years:
Yes
No
If yes, provide dates and types:
Claims in the past 3 years:
Yes
No
If yes, provide details on all claims (collision, comprehensive and glass claims):
License Suspension in the past 6 years:
Yes
No
If yes, provide details why your license was suspended, date of the suspension and date of reinstatement:
Cancellations for Non-Payment in the past 6 years:
Yes
No
If yes, provide details when cancelled and dates:
Add second driver?
Yes
No
DRIVER #2 INFORMATION
Name
First
Last
Age
Gender
Male
Female
Prefer Not to Answer
Drives Which Vehicle?
Vehicle #1
Vehicle #2
Vehicle #3
Please select all that apply.
Percentage of use of this vehicle:
How long licensed?
Previous Commercial Experience
None
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
More than 6 Years
Please Select One
Number of years experienced driving listed vehicle or similar type of vehicle
Drivers License No.
License Expiry Date
YYYY
MM
DD
License Dates:
All fields below are required. If not applicable, please indicate N/A.
G (yyyy/mm)
G1 (yyyy/mm)
G2 (yyyy/mm)
A (yyyy/mm)
AZ (yyyy/mm)
Other Class Type & Date (yyyy/mm)
Approved Driver's Training
Yes
No
Consecutively insured for:
None
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7+ Years
Please Select One
Minor Convictions in the past 3 years:
Yes
No
If yes, provide dates and types:
Major Violations in the past 3 years:
Yes
No
If yes, provide dates and types:
Claims in the past 3 years:
Yes
No
If yes, provide details on all claims (collision, comprehensive and glass claims):
License Suspension in the past 6 years:
Yes
No
If yes, provide details why your license was suspended, date of the suspension and date of reinstatement:
Cancellations for Non-Payment in the past 6 years:
Yes
No
If yes, provide details when cancelled and dates:
Add Third Driver?
Yes
No
DRIVER #3 INFORMATION
Name
First
Last
Age
Gender
Male
Female
Prefer Not to Answer
Drives Which Vehicle?
Vehicle #1
Vehicle #2
Vehicle #3
Please select all that apply.
Percentage of use of this vehicle:
How long licensed?
Previous Commercial Experience
None
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
More than 6 Years
Please Select One
Number of years experienced driving listed vehicle or similar type of vehicle
Drivers License No.
License Expiry Date
YYYY
MM
DD
License Dates:
All fields below are required. If not applicable, please indicate N/A.
G (yyyy/mm)
G1 (yyyy/mm)
G2 (yyyy/mm)
A (yyyy/mm)
AZ (yyyy/mm)
Other Class Type & Date (yyyy/mm)
Approved Driver's Training
Yes
No
Consecutively insured for:
None
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7+ Years
Please Select One
Minor Convictions in the past 3 years:
Yes
No
If yes, provide dates and types:
Major Convictions in the past 3 years:
Yes
No
If yes, provide dates and types:
Claims in the past 3 years:
Yes
No
If yes, provide details on all claims (collision, comprehensive and glass claims):
License Suspension in the past 6 years:
Yes
No
If yes, provide details why your license was suspended, date of the suspension and date of reinstatement:
Cancellations for Non-Payment in the past 6 years:
Yes
No
If yes, provide details when cancelled and dates:
Additional Comments/Information
Speak with a Specialist
oakville office
Give us a call at
905.847.0400
Send us an Email
Home
SERVICES
Auto
Home
Life
Commercial
Travel
Back
GROUP INSURANCE
Paintshop Insurance
Bikeshop Insurance
CAPS Insurance
Cannabis Retailers Insurance
Back
Join Our Team
Branch Office Opportunities
Employment Opportunities
Back
RESOURCES
FAQ’s
Glossary of Terms
Disclaimers
Back
Claims
CONTACT
